Provider Demographics
NPI:1992276836
Name:MOWLANA, AZRA (LMFT)
Entity type:Individual
Prefix:
First Name:AZRA
Middle Name:
Last Name:MOWLANA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21051 WARNER CENTER LN STE 105
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6532
Mailing Address - Country:US
Mailing Address - Phone:818-610-3956
Mailing Address - Fax:818-610-3912
Practice Address - Street 1:10507 MASON AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-3315
Practice Address - Country:US
Practice Address - Phone:818-307-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100284106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist